Atlanta Pediatric Nutrition, INC.
Dietitian, Registered, Nutrition, Pediatric in Woodstock, GA. Organization (NPI-2).
NPI number1558096479
StatusActive
Last updated in NPPESJul 24, 2022
Details
- NPI
- 1558096479
- Entity type
- Organization (NPI-2)
- Legal business name
- Atlanta Pediatric Nutrition, INC.
- Organization subpart
- No
- Enumeration date
- Jul 24, 2022
- Certification date
- Jul 24, 2022
- Last updated
- Jul 24, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133VN1004X | Dietitian, Registered, Nutrition, Pediatric | – | – | Yes |
Practice location
140 Rocky Creek TrlWoodstock, GA 30188-6246
Phone 404-543-3897 · Fax 404-745-0808
Mailing address
140 Rocky Creek TrlWoodstock, GA 30188-6246
Phone 404-543-3897 · Fax 404-745-0808
Authorized official
Helen Bailey Koch
President
4045433897
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